Endocrine Abstracts

Background: Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) can cause long-term morbidity and death. Studies indicate that this may partially be due to transient or chronic hypopituitarism (HP). Guidelines recommend screening for HP in moderate and severe TBI patients (TBIp), Glasgow coma score (GCS) 9–12 and <9 respectively. The aim of this study was to evaluate markers of severity and physiologic changes as predictive factors for HP following TBI and SAH.

Subjects and methods: During 12 months, patients admitted to the National University Hospital were included, 21 TBIp, (6 moderate, 15 severe, 17 males, 4 females, mean age 34±13 years) and 19 patients with SAH (SAHp) (12 males, 7 females, mean age 54±14 years). Baseline hormone levels were measured on admission and on day 6 when a synacthen test was also performed. Variables recorded were GCS, Hunt and Hess grade (SAHp), Injury severity score (TBIp), APACHEII, length of ICU stay and occurrence of systolic blood pressure (SBP) <90 mmHg and SpO2 <90% anytime during the first 24 h. Correlation was tested in SPSS using Spearmans rho (rho).

Results: On day 6, 9 of 21 TBIp, and 5 of 19 SAHp, had HP of one or more axis. Lost to follow up on day 6 were 4 TBIp and 3 SAHp. A significant correlation was found between length of ICU stay and any HP (rho 0.473, P<0.01) and occurrence of SBP below 90 mmHg during hours 2–24 (rho 0.337, P<0.05). Correlation between HP and other variables was non-significant.

Conclusion: The prevalence of HP in the acute phase following TBI and SAH was 42.9% and 26.3% respectively. The length of ICU stay and episodes of SBP below 90 mmHg during hours 2–24 may indicate HP. Further studies are needed on predictive factors making screening for HP following TBI and SAH effective.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.